SARS-COV-2 and Ocular Surface: From Physiology to Pathology, a Route to Understand Transmission and Disease
Coronaviruses gained public attention during the severe acute respiratory syndrome (SARS) outbreak in East Asia in 2003 and spread of Middle Eastern respiratory syndrome (MERS) in 2012. Direct human-to-human contact and droplet are the main methods of transmission. Viral stability in aerosols on dif...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-02-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2021.612319/full |
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| author | Dalton de Freitas Santoro Luciene Barbosa de Sousa Niels O. S. Câmara Niels O. S. Câmara Denise de Freitas Lauro Augusto de Oliveira |
| author_facet | Dalton de Freitas Santoro Luciene Barbosa de Sousa Niels O. S. Câmara Niels O. S. Câmara Denise de Freitas Lauro Augusto de Oliveira |
| author_sort | Dalton de Freitas Santoro |
| collection | DOAJ |
| description | Coronaviruses gained public attention during the severe acute respiratory syndrome (SARS) outbreak in East Asia in 2003 and spread of Middle Eastern respiratory syndrome (MERS) in 2012. Direct human-to-human contact and droplet are the main methods of transmission. Viral stability in aerosols on different surfaces supports evidence on indirect viral acquisition from fomites through the mucous membranes of the mouth, nose, and eyes. Given the pandemic circumstances, the level of evidence in COVID-19 and ophthalmology regarding eye infection, conjunctival transmission, and viral shedding through tears is insufficient. Presently, conjunctival transmission of coronaviruses has not been confirmed and remains controversial. Considering the physiology of the lacrimal system and ocular surface, the eyes are considered an immunoprotective site, with several antiviral molecules and anti-inflammatory proteins. Nevertheless, they represent an interface with the exterior world and face daily putative aggressors. Understanding the host’s ocular surface immunological and protective environment is crucial to clarify the potential of the conjunctiva as an entry route for SARS-CoV-2 and as part of this viral infection. We will discuss hypothetical ocular surface transmission mechanisms and related counterarguments addressed to both angiotensin-converting enzyme 2 receptors found on the conjunctival and corneal epithelia and lactoferrin, lysozyme, lipocalin and secretory IgA levels in the tear film. Hopefully, we will promote better understanding of this organ in COVID-19 infection and the potential transmission route that can be helpful in setting recommendations on best practices and protective guidelines to mitigate the disease spread. |
| first_indexed | 2024-12-21T14:12:41Z |
| format | Article |
| id | doaj.art-89a0887416664218bed2438a6efad1d3 |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-12-21T14:12:41Z |
| publishDate | 2021-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Physiology |
| spelling | doaj.art-89a0887416664218bed2438a6efad1d32022-12-21T19:01:00ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2021-02-011210.3389/fphys.2021.612319612319SARS-COV-2 and Ocular Surface: From Physiology to Pathology, a Route to Understand Transmission and DiseaseDalton de Freitas Santoro0Luciene Barbosa de Sousa1Niels O. S. Câmara2Niels O. S. Câmara3Denise de Freitas4Lauro Augusto de Oliveira5Department of Ophthalmology and Visual Science, Federal University of São Paulo, São Paulo, BrazilDepartment of Ophthalmology and Visual Science, Federal University of São Paulo, São Paulo, BrazilDepartment of Immunology, Institute of Biomedical Sciences IV, University of São Paulo, São Paulo, BrazilNephrology Division, Federal University of São Paulo, São Paulo, BrazilDepartment of Ophthalmology and Visual Science, Federal University of São Paulo, São Paulo, BrazilDepartment of Ophthalmology and Visual Science, Federal University of São Paulo, São Paulo, BrazilCoronaviruses gained public attention during the severe acute respiratory syndrome (SARS) outbreak in East Asia in 2003 and spread of Middle Eastern respiratory syndrome (MERS) in 2012. Direct human-to-human contact and droplet are the main methods of transmission. Viral stability in aerosols on different surfaces supports evidence on indirect viral acquisition from fomites through the mucous membranes of the mouth, nose, and eyes. Given the pandemic circumstances, the level of evidence in COVID-19 and ophthalmology regarding eye infection, conjunctival transmission, and viral shedding through tears is insufficient. Presently, conjunctival transmission of coronaviruses has not been confirmed and remains controversial. Considering the physiology of the lacrimal system and ocular surface, the eyes are considered an immunoprotective site, with several antiviral molecules and anti-inflammatory proteins. Nevertheless, they represent an interface with the exterior world and face daily putative aggressors. Understanding the host’s ocular surface immunological and protective environment is crucial to clarify the potential of the conjunctiva as an entry route for SARS-CoV-2 and as part of this viral infection. We will discuss hypothetical ocular surface transmission mechanisms and related counterarguments addressed to both angiotensin-converting enzyme 2 receptors found on the conjunctival and corneal epithelia and lactoferrin, lysozyme, lipocalin and secretory IgA levels in the tear film. Hopefully, we will promote better understanding of this organ in COVID-19 infection and the potential transmission route that can be helpful in setting recommendations on best practices and protective guidelines to mitigate the disease spread.https://www.frontiersin.org/articles/10.3389/fphys.2021.612319/fullCOVID-19SARS-COV-2ocular surfaceACE2 receptorconjunctivaIgA |
| spellingShingle | Dalton de Freitas Santoro Luciene Barbosa de Sousa Niels O. S. Câmara Niels O. S. Câmara Denise de Freitas Lauro Augusto de Oliveira SARS-COV-2 and Ocular Surface: From Physiology to Pathology, a Route to Understand Transmission and Disease Frontiers in Physiology COVID-19 SARS-COV-2 ocular surface ACE2 receptor conjunctiva IgA |
| title | SARS-COV-2 and Ocular Surface: From Physiology to Pathology, a Route to Understand Transmission and Disease |
| title_full | SARS-COV-2 and Ocular Surface: From Physiology to Pathology, a Route to Understand Transmission and Disease |
| title_fullStr | SARS-COV-2 and Ocular Surface: From Physiology to Pathology, a Route to Understand Transmission and Disease |
| title_full_unstemmed | SARS-COV-2 and Ocular Surface: From Physiology to Pathology, a Route to Understand Transmission and Disease |
| title_short | SARS-COV-2 and Ocular Surface: From Physiology to Pathology, a Route to Understand Transmission and Disease |
| title_sort | sars cov 2 and ocular surface from physiology to pathology a route to understand transmission and disease |
| topic | COVID-19 SARS-COV-2 ocular surface ACE2 receptor conjunctiva IgA |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2021.612319/full |
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